On June 24, 2007, at approximately 3:15 p.m., W.S.' was bitten by a poisonous spider while walking in the hallway of Coalinga State Hospital. W.S. states he felt a sharp pain in his left shoulder, as if from an insect bite. He reached back and removed a brown spider approximately one-half inch in diameter from under his shirt.

W.S. immediately returned to his housing unit and reported the spider bite to level of care staff, a psychiatric technician ("Psych. Tech."). She told W.S. to come back in one hour and she would check the site of the bite to see what it looked like then. During the ensuing hour, W.S. states that the spot throbbed with intense pain. When he returned to the MedRoom after the one hour wait, the Psych. Tech. said that it looked structurally similar to a pimple. W.S. described the intense pain he was suffering to the Psych. Tech., and then requested the Nursing Officer of the Day ("NOD") be called.

The NOD was called, but stated that since W.S. wasn't dying, he should just be placed on sick call for the following day. However, in spite of his continual complaints of intense pain to level of care staff, he was not seen until three days later. Apparently pain and suffering is also OK if you are a patient at CSH!

On June 07, 2007 (at approximately 10:00 a.m.), W.S. was finally called to the CSH Clinic for sick call, where he was seen by Dr. Johnny Dang (M.D.). Dr. Dang looked at the bite site on his shoulder and said that it looked to him like a mosquito bite or a pimple. Dr. Dang placed W.S. on antibiotics for one week. The order for antibiotics was discontinued on approximately June 14, 2007, apparently without any follow-up visit.

In spite of W.S.'s continuing complaints of intense pain from the spider bite, nothing more was done. Then, eighteen days after the spider bite, on June 22, 2007 at approximately 3:00 a.m., W. S. states a horrendous smell woke him up from sleep. When he woke up enough to be semi-coherent, he realized that the smell was coming from his immediate bed area. As he came further awake, he realized that he had the sensation of something liquid-like on his left shoulder. He reached back and felt the place where the spider had bitten him on June 04, 2007. What he felt at the bite area was a thick, sticky fluid leaking from the spider bite. The fluid had a rancid odor! It had the strong smell of rot.

W. S. immediately got out of bed and went to the nursing station in order to report this latest problem to the on-duty psychtech. When the Psych-Tech opened the office door, she immediately asked, "What is that smell?" W.S. showed her the bite site and she asked what it was. He told her it was a spider bite. She told him that it was oozing fluid. She cleaned the site up and then called the NOD to come and see it. The NOD did not arrive until after 7:30 a.m. - approximately three '/z hours after being called. The NOD took W.S. into the examining room and once inside, she pressed on the bite site and lots of the rancid smelling, sticky fluid came from the site. The NOD said that she'd never seen anything like that before and asked what had happened. W.S. reported that a spider had bitten him. She said that he had to see a doctor immediately, and referred him to Dr. Dang.

W. S. was seen by Dr. Dang that same day, at which time Dr. Dang appeared surprised by the current state of the bite site. He asked some questions about what had been happening since he'd last seen W.S., and then told him that the site had to be cut open; that he was going to schedule him for surgery.

The next day, Linda [an R.N.] came to see W.S. on his housing unit, and she examined the spider bite area. Immediately upon smelling the wound site, Linda told him that he had an enormous infection and needed to have immediate surgery.

Twenty three days after the spider bite, on the morning of June 27, 2007, W.S. learned that he was scheduled for a 9:00 a.m. appointment at the Clinic (Med-Surg). He reported to that location on time, and after waiting for an hour, asked at the desk what was going on. The staff acknowledged that he indeed had an appointment to see the surgeon, but that the surgeon was not in. The staff member said that she had been instructed to reschedule him to see the surgeon at a later date.

He explained that he needed to have the surgery right away, but the staff member said that she was just following orders. She said that she'd reschedule him for one-and-a-half weeks in the future. W.S. told them that they were not paying attention to the seriousness of the situation, but she again said that she was simply following orders.

The next morning (June 28, 2007), the unit nurse stopped W. S. and inquired as to how many stitches he had received from the surgery, and if the stitches itched. W.S. reported that he hadn't had surgery and that it was postponed for a week and a half. Her response was, "No way! That is not going to happen. That problem will not wait that long." She immediately went and made phone calls. Apparently, nothing could be done to expedite the appointment.

Approximately 38 days after the spider bite, in mid July, which was two weeks after the cancelled surgery appointment, W.S. was finally seen by the surgeon who told him that he was placing W.S. on antibiotics once again. The surgeon wanted them built-up in his system before the surgery. The surgeon scheduled him for surgery two weeks later, which was August O1, 2007. The surgery was finally done on August O1, 2007, 58 days after the spider bite.

After the surgery, the surgeon showed W.S. a mass, inside of a sterile sample cup of some sort. The mass was approximately 1" in diameter. The surgeon told him his skin had grown around it due to the antibiotics he had been taking. The antibiotics had caused the opening in the skin that was created by the spider bite to seal, and his body's defense system had tried to fight the infection. This had caused the mass of flesh to actually be killed by the poison. The surgeon had dug the mass out, cauterized the wound, sewed it up (eight stitches), and placed his iett arm in a sling. The surgeon instructed W.S. to take it easy. In the mean time, the hospital threatened to remove him from his vocational work assignment because he was not reporting to participate.

At a follow-up visit with a Physician's Assistant on August 16, 2007, W. S. was told that the wound is now healing nicely, but he would have a hole in his shoulder for the rest of his life.

W.S. now complaints that due to Dr. Dang's failure to properly diagnose the problem, coupled with the lack of an adequate follow-up procedure, he ended-up needing to have his flesh cut away and is now permanently maimed. Had Dr. Dang properly diagnosed the problem, and then provided appropriate treatment, this would have prevented the spider's poison from causing his flesh to die and then rot for an additional 58 days, thus requiring surgical removal. Had an adequate follow up procedure been in place, one in which an appointment missed by the surgeon was rescheduled for the next available date, rather than two weeks into the future, the spider's poison would not have been able to keep killing his flesh unabated for a period of two additional weeks.

Dr. Dang erred when diagnosing W.S.'s medical condition and the seriousness of a spider bite. Particularly when the description of the spider, and the intense pain associated with the bite, should have triggered the suspicion that the spider in question was a poisonous spider. Especially since poisonous spiders are known to be in the area, and toxicology reports did later confirm that the wound area had been injected with a poison.

Equally egregious to the original diagnosis were the cavalier attitudes by medical staff in general, who paid no attention to his pain and suffering when stalling and delaying actual treatment. The stalling continued even after the rotting flesh and seriousness of the wound area were discovered. The conduct of the medical department was truly negligent and constituted malpractice.

W.S. states that he now knows personally what the other patients at CSH have been complaining about regarding the lack of proper, timely medical care and treatment.

Because the State had involuntarily detained W.S., he was unable to obtain medical care for himself and therefore had to depend on the State to provide that care. When the State failed to provide that care, as it did in this case, not only was W.S.'s life placed in danger, but also he has now been maimed for life.
 

1 Only the initials of the patient will be used herein to protect his privacy rights pursuant to the Health Information Practices Act ("HIPA").